{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T14:41:16Z","timestamp":1758033676730,"version":"3.44.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Leprosy, also known as Hansen\u2019s disease, is a chronic infectious disease caused by <jats:italic>Mycobacterium leprae<\/jats:italic>. It primarily affects the skin, peripheral nerves, mucous membranes, and the eyes. If left untreated, it can lead to severe nerve damage, deformities, and permanent disabilities. According to a report by the World Health Organization in 2023, there were approximately 180,000 new cases globally. From 2014 to 2023, the total number of new cases worldwide decreased by 14.6%. Although certain achievements have been made in the prevention and control of leprosy, there are still deep-rooted misunderstandings and prejudices regarding leprosy in society. Consequently, patients and their families suffer from discrimination and exclusion in many aspects of life, making it difficult for them to truly integrate into society.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 52-year-old Dai pepole woman presented with the chief complaints of \u201cgeneralized edema for 6\u202fmonths and erythema and numbness of the hands and feet for 3\u202fmonths.\u201d Through histopathological examination, acid-fast staining, and Bacterial Index (BI) testing, she was diagnosed with borderline lepromatous leprosy. She was administered a multi-bacillary multidrug therapy (MDT-MB) regimen for anti-leprosy treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report a case of borderline lepromatous leprosy with generalized swelling as the initial symptom and review and analyze misdiagnosed and rare cases reported in the literature. The aim is to provide clinicians with more diagnostic ideas and reference bases and to promote the further development of leprosy prevention and control work.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1636112","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T13:58:33Z","timestamp":1758031113000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A case of borderline lepromatous leprosy and literature review\u2014key clues to expand clinical diagnostic thinking"],"prefix":"10.3389","volume":"12","author":[{"given":"Li","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kui","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xian-wen","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-jian","family":"Hua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"ref1","volume-title":"The netter collection of medical illustrations","author":"Anderson","year":"2017"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e47859","DOI":"10.7759\/cureus.47859","article-title":"Lepromatous leprosy manifesting as chronic macrocheilia: report of a rare case","volume":"15","author":"Panigrahi","year":"2023","journal-title":"Cureus"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"204","DOI":"10.35541\/cjd.20220512","article-title":"Epidemiological characteristics of leprosy in China from 2016 to 2020","volume":"56","author":"Sun","year":"2023","journal-title":"Chin J Dermatol"},{"key":"ref4","volume-title":"Dermatology","author":"Bolognia","year":"2010"},{"key":"ref5","year":"2022"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1590\/abd1806-4841.20163661","article-title":"Leprosy among children under 15 years of age: literature review","volume":"91","author":"Oliveira","year":"2016","journal-title":"An Bras Dermatol"},{"key":"ref7","first-page":"255","article-title":"Classification of leprosy according to immunity. A five-group system","volume":"34","author":"Ridley","year":"1966","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"ref8","year":"2022"},{"key":"ref9","year":"2018"},{"key":"ref10","first-page":"1","article-title":"WHO Expert Committee on Leprosy","volume":"874","year":"1998","journal-title":"World Health Organ Tech Rep Ser"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e11616","DOI":"10.1097\/MD.0000000000011616","article-title":"Borderline tuberculoid leprosy mimicking sarcoidosis: a case report","volume":"97","author":"Liu","year":"2018","journal-title":"Medicine"},{"key":"ref12","first-page":"379","article-title":"Borderline tuberculoid leprosy mimicking mycosis fungoides","volume":"11","author":"Rodr\u00edguez-Acosta","year":"2013","journal-title":"Skinmed"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijid.2014.02.004","article-title":"A case of lepromatous leprosy complicated by hemophagocytosis misdiagnosed ashemophagocytic lymphohistiocytos is","volume":"23","author":"Zeng","year":"2014","journal-title":"Int J Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"116622","DOI":"10.1016\/j.diagmicrobio.2024.116622","article-title":"Mycobacterium leprae infection with rash misdiagnosed as a flare-up of systemic lupus erythematosus: a case report","volume":"111","author":"Zhao","year":"2025","journal-title":"Diagn Microbiol Infect Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.annder.2015.04.013","article-title":"Une l\u00e8pre l\u00e9promateuse r\u00e9v\u00e9l\u00e9e par des papules palmo-plantaires Lepromatous leprosy revealed by palmoplantar papular lesions","volume":"142","author":"Chaabane","year":"2015","journal-title":"Ann Dermatol Venereol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.ad.2015.08.010","article-title":"Pruritic lesions during pregnancy: an unusual presentation of a rare variant of multibacillary leprosy","volume":"107","author":"S\u00e1nchez-Orta","year":"2016","journal-title":"Actas Dermosifiliogr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"107004","DOI":"10.1016\/j.ijid.2024.107004","article-title":"A case of leprosy in a nonendemic country","volume":"143","author":"Asperges","year":"2024","journal-title":"Int J Infect Dis"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1007\/s00415-015-7864-7","article-title":"An inflammatory myopathy unmasks a case of leprosy in an Italian patient","volume":"262","author":"Liguori","year":"2015","journal-title":"J Neurol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1111\/ced.12607","article-title":"Painful swelling on the side of the knee","volume":"40","author":"Jain","year":"2015","journal-title":"Clin Exp Dermatol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/qjmed\/hcu131","article-title":"Isolated superficial peroneal neuropathy: a rare presentation of Hansen's disease(leprosy)","volume":"108","author":"Maurya","year":"2015","journal-title":"QJM"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1590\/s0004-282x1999000500001","article-title":"Muscle involvement in leprosy. Study of the anterior tibial muscle in 40 patients","volume":"57","author":"Werneck","year":"1999","journal-title":"Arq Neuropsiquiatr"},{"key":"ref22","first-page":"348","article-title":"A histopathologic study of striated muscle biopsies in leprosy","volume":"43","author":"Gupta","year":"1975","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1007\/s10067-013-2276-5","article-title":"Leprosy in a rheumatology setting: a challenging mimic to expose","volume":"32","author":"Salvi","year":"2013","journal-title":"Clin Rheumatol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s12941-022-00532-4","article-title":"Next-generation sequencing-assisted diagnosis of a case of leprosy misdiagnosed as erythema multiforme","volume":"21","author":"Zhang","year":"2022","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"916319","DOI":"10.3389\/fimmu.2022.916319","article-title":"Fever of unknown origin, wasting syndrome and bone marrow involvement: a leprosy case report","volume":"13","author":"Santana","year":"2022","journal-title":"Front Immunol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"862","DOI":"10.24953\/turkjped.2023.138","article-title":"Childhood borderline lepromatous leprosy: a case report","volume":"65","author":"Hutahaean","year":"2023","journal-title":"Turk J Pediatr"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3390\/idr17040083","article-title":"Erythema nodosum leprosum in a patient with borderline lepromatous leprosy: a case report","volume":"17","author":"Chiriboga","year":"2025","journal-title":"Infect Dis Rep"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/j.abd.2024.10.004","article-title":"Borderline lepromatous leprosy with lymph node infiltration: dermatology helps to clarify challenging diagnoses","volume":"100","author":"Reis","year":"2025","journal-title":"An Bras Dermatol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"100134","DOI":"10.1016\/j.jctube.2019.100134","article-title":"A unique case of borderline lepromatous leprosy with psoriasis-like lesions all over the body and mycosis fungoides-like lesions on the face","volume":"17","author":"Gunawan","year":"2019","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e251798","DOI":"10.1136\/bcr-2022-251798","article-title":"Palatal perforation in a patient with borderline lepromatous leprosy: leprosy still not eradicated","volume":"15","author":"Anand","year":"2022","journal-title":"BMJ Case Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"6896","DOI":"10.1155\/2016\/1746896","article-title":"A rare case of coexistence of borderline lepromatous leprosy with tuberculosis Verrucosa Cutis","volume":"2016","author":"Dey","year":"2016","journal-title":"Case Rep Infect Dis"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e459","DOI":"10.4317\/medoral.15.e459","article-title":"Oro-facial aspects of leprosy: report of two cases with literature review","volume":"15","author":"Ghosh","year":"2010","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.abd.2020.03.022","article-title":"Case for diagnosis. Erythematous and infiltrated plaques in the infrahyoid region","volume":"96","author":"Bezerra","year":"2021","journal-title":"An Bras Dermatol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e80822","DOI":"10.7759\/cureus.80822","article-title":"Leprosy mimicking thrombangiitis obliterans (Buerger's disease): a case study","volume":"17","author":"Sena","year":"2025","journal-title":"Cureus"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"7","DOI":"10.5070\/D365h88318","article-title":"A case of Hansen disease presenting as tinea versicolor","volume":"19","author":"Yang","year":"2013","journal-title":"Dermatol Online J"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"316","DOI":"10.47276\/lr.84.4.316","article-title":"Optic nerve involvement in a borderline lepromatous leprosy patient on multidrug therapy","volume":"84","author":"Prabha","year":"2013","journal-title":"Lepr Rev"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"329","DOI":"10.4103\/apjtm.apjtm_874_23","article-title":"Borderline lepromatous leprosy: a case report","volume":"17","author":"Fernando","year":"2024","journal-title":"Asian Pac J Trop Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"202","DOI":"10.47276\/lr.83.2.202","article-title":"Borderline-lepromatous leprosy manifesting as granulomatous mastitis","volume":"83","author":"Pandhi","year":"2012","journal-title":"Lepr Rev"},{"key":"ref39","first-page":"223","article-title":"Sub-polar lepromatous leprosy presenting as urticarial wheals: a case report","volume":"76","author":"Barman","year":"2004","journal-title":"Indian J Lepr"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"336","DOI":"10.5935\/0305-7518.19970043","article-title":"Diffuse alopecia of the scalp in borderline-lepromatous leprosy in an Indian patient","volume":"68","author":"Abraham","year":"1997","journal-title":"Lepr Rev"},{"key":"ref41","first-page":"311","article-title":"Reactive episodes in borderline lepromatous leprosy--a case report","volume":"48","author":"Acharya","year":"1976","journal-title":"Lepr India"},{"key":"ref42","first-page":"83","article-title":"Non pitting edema, arthritis and ichthyosis; presenting manifestation of leprosy","volume":"85","author":"Moulick","year":"2013","journal-title":"Indian J Lepr"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1136\/postgradmedj-2019-136392","article-title":"Leprosy neuropathy masquerading as cellulitis","volume":"95","author":"Sumangala","year":"2019","journal-title":"Postgrad Med J"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1186\/s12879-019-4098-9","article-title":"Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome-a case report","volume":"19","author":"Guerra","year":"2019","journal-title":"BMC Infect Dis"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1001\/jamadermatol.2016.4261","article-title":"Swollen hand joints with asymptomatic nodules on the skin","volume":"153","author":"Qu","year":"2017","journal-title":"JAMA Dermatol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"746","DOI":"10.55563\/clinexprheumatol\/ov3kgl","article-title":"Leprosy mimicking autoimmune diseases: a case series","volume":"42","author":"Aride","year":"2024","journal-title":"Clin Exp Rheumatol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1416177","DOI":"10.3389\/fimmu.2024.1416177","article-title":"An update on leprosy immunopathogenesis: systematic review","volume":"15","author":"Silva","year":"2024","journal-title":"Front Immunol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/s41572-024-00575-1","article-title":"Leprosy","volume":"10","author":"Grijsen","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"329","DOI":"10.4103\/0019-5154.113979","article-title":"Recurrent ulcers: a diagnostic challenge","volume":"58","author":"Thomas","year":"2013","journal-title":"Indian J Dermatol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1111\/j.1756-185X.2009.01382.x","article-title":"Lest we forget Hansen's disease (leprosy): an unusual presentation with an acute onset of inflammatory polyarthritis and the rheumatology experience","volume":"12","author":"Sheetal","year":"2009","journal-title":"Int J Rheum Dis"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e13451","DOI":"10.7759\/cureus.13451","article-title":"Chronic hand swelling and Dactylitis in leprosy: a case report and review of the literature","volume":"13","author":"Gupta","year":"2021","journal-title":"Cureus"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1636112\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T13:58:37Z","timestamp":1758031117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1636112\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":51,"alternative-id":["10.3389\/fmed.2025.1636112"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1636112","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]},"article-number":"1636112"}}